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COVID 19 and diabetes: a lethal partnership? How do we overcome this?

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By Dr. Kayathri Periasamy

With the latest wave of COVID-19 infections sweeping steadily across Sri Lanka, attention has been directed towards persons with uncontrolled, pre-existing conditions, particularly diabetes; as a sect most vulnerable to get severely ill or die because of complications caused by the virus. This has shed light on another growing concern among healthcare providers and patients, which is that patients suffering from diabetes or other chronic conditions are finding it increasingly difficult or are unable to access the medical care they require due to mandatory albeit essential curfew measures combined with a deep fear of contracting the virus in communal healthcare settings.

With a staggering 463 million adult diabetic patients present worldwide, World Diabetes Day 2020 – falling on the 14th of November- is a critical time for diabetes support communities and healthcare advocates to rally together to create awareness about this debilitating medical condition and push for progress in the standards of care and the better management of diabetic patients during a pandemic. In Sri Lanka alone, 1 in 10 adults are approximated to suffer from the disease. It is also then vital to look at ways to help stop more people from getting this disease, particularly at a time when ‘lockdown’ lifestyles are more often than not likely to be sedentary, unhealthy and stressful; an ideal background for a diabetes diagnosis.

Why is uncontrolled diabetes such a potent accelerant for COVID-19?

A recent study conducted by Lancet on Diabetes & Endocrinology screened over 61 million medical records in the U.K. to find that 30% of COVID-19 deaths can be attributed to people with diabetes. After accounting for factors such as demography and chronic medical conditions, the risk of succumbing to the virus was shown to be about three times higher for people with Type 1 diabetes and almost twice as high for Type 2, versus those without the disease. 

There appears to be two primary reasons driving this predicament. Over a lifetime, poor glucose control inflicts widespread damage in our systems which can lead to strokes, heart attacks, kidney failure, eye disease, and limb amputations. The linings of blood vessels throughout the body weaken to an extent where they can’t ferry necessary nutrients adequately. Inflammation is another byproduct of poor diabetes control, which makes the body ill-prepared for the onslaught of the viral disease. Secondly, the rich environment of elevated blood glucose present in diabetic patients, makes them prone to superadded bacterial complications during the viral infection. Many diabetics also tend to have other co-morbidities such as obesity, hypertension, and heart disease, which are all factors that aggravate complications during viral illneses. These problems are seen in any infections in the setting of diabetes and not only with COVID 19. The pandemic has just highlighted the difficulties of having diabetes

 

What precautions can diabetic patients take?

So during this pandemic, apart from strict adherence to general COVID-19 personal safety protocols such as strict social distancing and sanitization, it is important for patients to regularly monitor their glucose levels to avoid complications caused by fluctuating blood glucose. Proper hydration is essential for good health. It is also crucial to have access to a good supply of the prescribed diabetes medications and healthy food so that patients are able to correct the situation if blood glucose levels fluctuate. Finally, sticking to a comfortable daily routine, maintaining an exercise program even within the confines of your home, reducing excessive work and having a good night’s sleep can go a long way in keeping you strong. In essence, maintaining good blood sugar levels may be their best defense against severe COVID-19.

Disruption to continuity of care for diabetes patients

A rapid assessment survey conducted by WHO among Ministries of Health across many countries, focusing on the service delivery for NCDs during the COVID-19 pandemic, revealed deepening concerns that many people living with NCDs are no longer receiving appropriate treatment or access to medicines during the COVID-19 pandemic. The more severe the transmission phase of the COVID-19 pandemic, the more NCD care services were disrupted.

With our country currently in the cluster transmission phase and heading towards the community transmission phase due to the large and distant spread of the first-line contacts, the threat to NCD care and especially routine and emergency care of diabetes patients worries us physicians. As healthcare providers, we too are torn between the dilemma of not wanting to expose our patients to unnecessary hospital visits and the need to ensure that all our patients have continued access to their healthcare team along with a steady supply of medicines and other diabetes care products such as glucometer strips and insulin. Unfortunately, the delay in visiting their healthcare provider when they have symptoms of complications has caused many people to present late to the hospital with heart attacks or infections. A delayed presentation, weakens the patient further.

This disruption to healthcare services is foreseen to be a huge dilemma for patients and healthcare providers alike, especially when it comes to the care of patients with diabetes and other non-communicable diseases. In Sri Lanka, the Ministry of Health, is currently providing a number of telemedicine services and has opened avenues to deliver medicines to houses without diabetic persons having to visit crowded settings

 

How do we counter this?

At Healthy Life Clinic, we adhere strictly to COVID-19 safety operational health protocols established according to Ministry of Health (MOH), Epidemiology Unit. All incoming patients are screened by our nurses as soon as appointments are made over the phone, to understand the nature of their illness. If there is a worry that they could have contracted COVID-19 or have been in contact with such patients, they are given the opportunity to speak to the doctor first over the phone for a detailed history. Every patient will be consulted and no one is turned away from our care.

In order to help patients overcome barriers such as curfews or even the fear of entering communal healthcare settings, our experienced, highly-regarded team of consultants conducts telehealth consultations via established, trusted telemedicine partners such as oDoc and Mydoctor.lk to maintain continuity of care throughout this pandemic. We have also moved many of our long-standing diabetes care and weight management programs online, which have proven to be effective even in the absence of a physical meeting and examination. Additionally, our social media platforms and website are constantly updated to increase awareness about this condition, along with content that informs people about the proper management and prevention of diabetes – particularly when it is thus connected to COVID-19.

 

(Dr. Kayathri Periasamy is a consultant physician MBBS (UK), MRCP (UK), Board Certified in Int. Medicine (U.S.A). She is the founder of Healthy Life Clinic, Colombo 07.)



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‘Mangala Samaraweera – a democrat who opposed racism and corruption’

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Former President Chandrika Bandaranaike Kumaratunga / Late minister Mangala Samaraweera

‘The late Mangala Samaraweera was a true democrat who staunchly opposed racism in all its forms. He was also against corruption. He was a unique person, an achiever, an artist, a creative person, well-read and practical-minded, former President Chandrika Bandaranaike Kumaratunga said. She believes that if Mangala Samaraweera (MS) lived, Sri Lanka would have been changed entirely for the better.

The former President was speaking at a special Mangala Samaraweera commemorative event held at the auditorium of the Bandaranaike Centre for International Studies (BCIS), Colombo on April 22nd, which featured the donation of Minister Samaraweera’s wide-ranging and abundant private collection of books to several Sri Lankan libraries, including that at the BCIS and the Colombo Public Library.

The programme was termed, ‘Reading with Mangala: Insights into his Personal Library and its Onward Gifting to His Fellow Sri Lankans.’ The event marked MS’ 69th birthday.

The book donation was facilitated by the family of the late minister which coordinated closely with the BCIS to make the event a success. Besides former President Kumaratunga, the event was graced by the BCIS Council of Management, public personalities, associates and colleagues of the former minister, BCIS staffers, students and well-wishers.

At the outset of the commemoration, MS was introduced eloquently and at some length to the audience by the late minister’s niece, Chanchala. MS came across to us, basically, as a multi-talented, well-read, colourful and knowledgeable personality. A resourceful person who could change things for the better.

In a panel discussion featuring many dignitaries on Mangala the person and the public figure, former President Chandrika Bandaranaike Kumaratunga mentioned the following as well: ‘Mangala had a vision for the country as a public figure and conceptualized policies in accordance with it. Among other things, he persuaded the entire SLFP to resolve the ethnic issue by political means.

‘In a survey done by a foreign company it was revealed initially that only 23 percent of the country’s Sinhala community supported a political solution to the ethnic conflict. I asked Mangala to tell me how our ideas could be taken to the public. He launched work on this project with 19 ministers. One positive result from these deliberations was the ‘Sudu Nelum Movement’ which Mangala backed to the hilt.

‘Subsequently, the message of a negotiated solution was taken to the country through innovative means, like Street Theatre and the ‘Thawalama’ campaign. Mangala gave of his best to these projects. Subsequently, in a second survey done it was disclosed that 68 per cent of the people accepted a political solution. Thus, did Mangala’s positive approach pay off. He stuck to his principles and never betrayed them.’

By Lynn Ockersz

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Japan ready to take on fresh loan projects for Sri Lanka – Ambassador Isomata

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Ambassador Akio Isomata (first from right) at the forum

Japan is ready to undertake fresh loan projects for Sri Lanka since the country has completed its debt restructuring process, Japanese ambassador to Sri Lanka Akio Isomata said.

“Japan is ready to consider taking on such commitments if there is a request from the Sri Lankan end but the undertaking of such projects depends on Sri Lanka’s debt servicing ability, ambassador Isomata added.

The ambassador made these remarks in response to a query raised during a round table discussion organised by the Pathfinder Foundation recently at the Taj Samudra’s Colombo Club. The theme of the event was, “Japan’s response to the US reciprocal tariffs and Japan- Sri Lanka relations in a turbulent world”. The forum was presided over by Pathfinder Foundation chairman ambassador Bernard Goonetilleke.

The ambassador also said that Japan was a victim of corruption in Sri Lanka and expressed optimism that the government would tackle the issue.

“Earlier, there were reports about some Japanese companies facing issues in Sri Lanka in securing investments. Japanese companies strictly observe compliance obligations and therefore never offer bribes or kickbacks, ambassador Isomata explained. Ambassador Isomata said that he attended the function to mark the launch of the ‘National Anti -Corruption Action Plan’ and listened to President Anura Kumara Dissanayake speaking of efforts to address the issue. The ambassador emphasized the need to implement the plan.

Responding to the President’s remarks that politicians belonging to his National People’s Power (NPP) are not involved in any form of corruption, the ambassador said it is equally important to address the same involving Sri Lankan bureaucrats.

Commenting on Japan- Sri Lanka bilateral relations, Isomata said Sri Lanka is a very important partner for Japan in many ways.” As Sri Lanka’s economy is in the process of getting back on track with efforts underway to implement the IMF agreement, along with the debt restructuring agreement, I don’t think Japanese companies will come immediately to make new investments at this stage. But as the Sri Lankan economy goes back on track in a stable manner, I think we can cultivate the interest of Japanese investors to take a closer look at opportunities in Sri Lanka for further investment. We need cooperation with Sri Lankan people, he said.

The ambassador added: “We are seeing increasing numbers of young Sri Lankans going to Japan for employment in Japanese companies. There are two kinds of programmes for inviting young foreign workers into Japan right now.

“One is called the TITP -Technical Intern Training Programme. The second one, recently started, is SSW -Specified Skilled Worker Programme. Under these two programmes, an increasing number of Sri Lankan youngsters are going to Japan right now. We have opened up eight industrial sectors for Sri Lankan workers, starting with caregiving, hotel accommodation, food industry, agriculture, construction and most recently, the transportation sector, like bus driving and truck driving. This will strengthen Japan’s labour market. We need a young labour force because Japan is facing the problem of an ageing society.”

By Hiran H Senewiratne

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SLT-MOBITEL surges ahead with robust Q1 2025 profit growth

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Janaka Abeysinghe, Chief Executive Officer SLT Group

The SLT Group has reported a Profit After Tax (PAT) of Rs. 2,001 million for the first quarter ended March 31, 2025, a surge from Rs. 156 million in Q1 2024, reflecting effective financial management and improved operational efficiency.

SLT Group demonstrated strong performance for the first quarter of 2025, with revenue increasing 3.4% to Rs. 27,851 million. The growth was primarily driven by Mobitel’s contribution of increased revenues while SLT PLC revenue remained stable.

The Group’s cost optimization initiatives continued to yield positive results, with operating expenses decreasing 2.9% amount to Rs. 710 million compared to the same period last year. The reduction, combined with revenue growth, led to a 13% increase in EBITDA to Rs. 10,443 million.

At company level, SLT PLC reported a marginal 0.7% increase in revenue of Rs. 117 million compared to Q1 2024, primarily driven by growth in enterprise, small and medium enterprises (SMEs) and broadband streams.

SLT PLC also achieved significant cost declines, with operating expenses decreasing 5.2% amount to Rs. 838 million Year-on-Year (YoY). Notably, electricity expenses fell 38.3% following tariff reductions in March and July 2024. Vehicle hiring and fuel costs also decreased 22.7%, and repair and maintenance expenses curtailed by 12.5%.

SLT PLC specifically demonstrated impressive profit growth, with PAT increasing by 369.9% to Rs. 1,344 million compared to Rs. 286 million in Q1 2024. The notable performance was supported by a 380% surge in Profit Before Tax (PBT) to Rs. 1,920 million and a 60.3% increase in Operating Profit to Rs. 2,538 million.

Mobitel demonstrated strong financial performance in the first quarter of 2025, reporting notable revenue growth supported by the growth of data services. Total revenue reached Rs. 11.8 billion, reflecting the company’s success in capitalizing on demand for digital connectivity. Enhanced top-line performance, combined with effective cost reduction initiatives, led to a significant improvement in profitability.

EBITDA increased by 28.5%, resulting in a healthy EBITDA margin of 30%. Operating profit (EBIT) also recorded a marked improvement by 392%, with a 7% EBIT margin. PBT saw considerable growth, and the company successfully turned around its financial position, moving from a net loss in the first quarter of 2024 to a net profit of Rs. 477 million in the same period of 2025.

Reaffirming its commitment to delivering superior network experiences and the widest coverage across the island, SLT-MOBITEL Mobile was recognized as the country’s fastest 4G network for 2024 by Ookla®, the global leader in internet testing and analysis at Mobile World Congress Barcelona, held in March 2025.

Leveraging strong Q1 results as a foundation for 2025 growth, the SLT Group aims to continue the ongoing digital transformation journey delivering innovative solutions and expanding services to meet customer needs. Through operational efficiency and digital advancement, investing in advanced technologies to strengthen market position, the Group remains committed to supporting Sri Lanka’s digital economy and creating value for all stakeholders.

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